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We read with great interest the paper of Hurwitz et al.1 that demonstrated more appropriate American Society of Anesthesiologists Physical Status Classification System scores (ASA scores) and reduced interrater variability when the subjective examples provided to the ASA score2 were used. We suspect, however, that routine use of these examples may hinder the universal application of the ASA score. First, the examples provided are not fully comprehensive, and they will need to be memorized and easily accessible. Perhaps a mobile app could be created to calculate the correct ASA score, but even this does not guarantee uniform application. Second, as Sweitzer3 emphasized in the accompanying editorial, the universal successful application of the ASA score is related to its simplicity. The ASA score has penetrated beyond anesthesia and even beyond human medicine.4 It may even be considered on a par with the Apgar score.5

We hesitate to support the authors’ recommendation to use the examples to the ASA score, instead of using common sense and simple rules. Having a list of examples transforms a simple albeit subjective universal score into a cumbersome one. Keep it simple, stupid (KISS).6